2531 Measuring the quality of personal care in prostate cancer radiotherapy

Abstract

Background: Quality of care includes both technical and non-technical elements of care (personal care). We previously developed a questionnaire to assess the quality of personal care in prostate cancer radiotherapy. The objectives of this thesis were: 1) to determine which elements of personal care were most important to patients; 2) to develop a method of integrating ratings of importance and ratings of quality to identify elements of care that should become targets for quality improvement; 3) to describe the quality of personal care and identify the elements of care that should be targeted for quality improvement. Methods: We surveyed 108 patients undergoing radiotherapy for localized prostate cancer. Patients completed a self-administered questionnaire and rated both the importance and the quality of their care for each of the 143 elements. The importance and the quality of each element was measured by the percentage of respondents who rated it "very important" and "very good", respectively. Different methods for identifying elements to target for quality improvement were developed and compared. Results: The percentage of elements rated "very important" and "very good" varied from patient to patient. Aspects of care deemed important to most patients were: the perceived competence of their caregivers, the empathy and respectfulness of their caregivers, and the adequacy of information sharing. Patients assigned their lowest quality ratings to elements relating to the treatment environment and comprehensiveness of services, but they also rated these elements as relatively unimportant. We developed three methods of identifying priorities for quality improvement and found that incorporating importance ratings with quality ratings identified different priorities than quality ratings alone. One method was theoretically superior since the ratings for importance and quality were linked for each individual. Elements of care relating to communication of information about the disease and its treatment were identified as the highest priorities for improvement. iii Conclusions: We have developed indicators for measuring the quality of personal care in prostate cancer radiotherapy. We have shown that it is possible to measure the quality of personal care in routine practice and we developed a method for identifying priorities for quality improvement.